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What do I do if I think I may have an anxiety disorder?

The first thing to do is to talk to your primary care physician and have a complete physical examination done in order to rule out the possibility that you may have another non- anxiety based physical problem.  Many people with panic, for instance, have already visited the Hospital Emergency Department and have been ‘sent home’ because ‘nothing is wrong’.  Once your physician has determined that you have an anxiety disorder, talk to him or her about treatment resources available in your area. Psychiatrists, psychologists, clinical social workers who have specialized training in anxiety disorders are some of the mental health professionals that can be of help to you.  If you have to wait to get an appointment- don’t despair. Many cities and communities have organizations that offer self-help and support groups for people suffering with Anxiety Disorders. There are several self- help books available on the market and there are several websites which offer on-line support. These can all be invaluable sources of help to you in your recovery.

Currently, there are two main types of treatment which have been shown to be effective with anxiety disorders. Often the two treatments are used together; however each is effective on its own. These include:

  1. Pharmacological treatment
  2. Cognitive Behaviour Therapy (CBT)

Pharmacological treatment

This type of treatment involves the use of prescribed medications such as antidepressants which are designed to reduce the symptoms associated with anxiety and panic. These can be prescribed by your doctor or by a psychiatrist.  Every medication has side effects but these usually begin to disappear or are at least tolerated as your body gets used to them.  Once you have found one that is tolerable and effective for you, you will need to be on them for at the very least six months. Many now believe that you will need them for up to two years in order to repair some of the effects of the anxiety disorder or its often accompanying depression.  Some people may need to be on them for life.  These medications are usually well tolerated but to limit their side effects they should be started at a very low dose with the dose slowly raised.  Similarly when tapering them, they should be tapered very slowly. 

Other medication prescribed for anxiety disorders, include the benzodiazepines, (which should be prescribed at a low and regular dose) avoiding the "as required" approach.  Because of the risk of addiction, they are recommended to be prescribed for a very short period of time.

Often people with associated bipolar illnesses and people for whom one medication is not enough will require the addition of an atypical antipsychotic.  These agents can be very helpful to get the sufferer to complete recovery.


Psychological treatment

The main type of psychological treatment used to treat Anxiety Disorders is called Cognitive- Behaviour Therapy- otherwise known as CBT. Sometimes Behaviour Therapy alone is used.  CBT is done alone or in small groups. The Cognitive portion consists of identifying the thoughts and thought patterns that make you anxious and keep you anxious and then challenging them.  An example of this would be that as you begin to feel anxious you say to yourself:  “What if my dizziness means that I’m having a stroke?”  You might then be asked to evaluate this thought by finding out whether dizziness always implies a stroke, what other explanations there are for dizziness and what are the likely consequences of dizziness.

The Behavioural aspect involves challenging yourself to face the situations and sensations and thoughts that you may have come to avoid out of fear of feeling anxious. This is done is small, manageable steps called Exposure. Through exposing yourself in small steps you learn that you can feel anxious in a particular situation and you can still be ok. You learn that the anxiety isn’t going to kill you or make you go crazy. Eventually you learn to face the situations and sensations that you have been avoiding out of fear and you learn to gain control over the anxious feelings rather than letting them control you.  

Each anxiety disorder has a slightly different approach to treatment using this tool.

Social Anxiety Disorder
Treatment includes Individual or Group Cognitive Behaviour Therapy and/or medication.  The approach involves challenging the ideas that cause one to self punish or be harsh with one self.

Post Traumatic Stress Disorder
Cognitive Behaviour Therapy (CBT) and medication are the most commonly used treatments for Post Traumatic Stress Disorder.

Obsessive Compulsive Disorder
Obsessive Compulsive Disorder reponds well to Behaviour Therapy (sometimes called Exposure and Response Prevention) and Cognitive-Behaviour Therapy.  In addition, certain medications have also been shown to be effective in the treatment of Obsessive Compulsive Disorder.

Generalized Anxiety Disorder
Sometimes Generalized Anxiety Disorder is difficult to diagnose because it doesn’t have some of the more dramatic symptoms of, for example, Panic Disorder or Obsessive Compulsive Disorder. It is therefore very important to speak with your primary care physician about your condition. Currently, Cognitive Behaviour Therapy is used as a treatment method and could include: learning problem solving skills, learning to tolerate negative emotions and uncertainty, relaxation techniques, evaluating your thoughts and anxiety management tools.  As well, medication can be an effective tool for dealing with Generalized Anxiety Disorder.
  
Specific Phobia
Specific Phobias respond very well to Behaviour Therapy or Exposure Therapy.  There is emerging evidence that Cognitive- Behaviour Therapy is also very helpful in the treatment of phobias.  For most cases of Specific Phobia, however, there is no requirement for medication.

Panic Disorder
Panic Disorder responds well to Cognitive-Behaviour Therapy.  In addition, specific medications have also been shown to be effective in its treatment. In the case of agoraphobia, Cognitive- Behaviour Therapy alone is recommended.

Children and Youth
Treatment for children can include Cognitive- Behaviour Therapy as well as specific medications, although caution is required. Treatments are, however, applied differently with children than they are with adults due to the differences in age and/ or developmental stages of the children and youth in need.

We will have more detailed information about treatment for children and youth who suffer from anxiety disorders available in the coming months.

 

 
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ADAC/ACTA is not a referral service and we do not have mental health professionals on staff to answer questions. When possible please refer to our affiliate association in your province for references to services in your area.

QUEBEC (ATAQ): www.athaq.ca/
ONTARIO (ADAO): www.anxiety
disordersontario.ca
MANITOBA (ADAM): www.adam.mb.ca
BRITISH COLUMBIA (ADABC) : www.anxietybc.com

 
 
 

To contact us by email:
contactus@anxietycanada.ca

 
© Copyright 2007, Anxiety Disorders Association of Canada